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Look, Up in the Sky …

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Nahum Kovalski
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to
… [More]Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology. [Less]

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Although we are now in somewhat of a holding pattern (in terms of Israel versus Hamas), no one in Israel believes that this is the end of threats against our security. More so, so many countries around us are highly focused on our destruction (the most recent being ISIS). So, war is a constant concern in Israel both for our army and for the general population.

There is an old Jewish expression that says that we should hope for the best and plan for the worst. In planning for the worst, we need to consider how to maintain basic services even in a reality where bombs are falling from overhead on a constant basis. I will focus specifically on healthcare issues, but of course there are many other social issues that need to be addressed as well.

For many people, wars are effectively a lockdown period during which they cannot freely visit their physician or even go to the pharmacy to get their medications. What is needed is a set of alternative technologies that can, to a great extent, offer these services virtually. It is already years, that one of the Israeli health funds offers a web-based consultation, using a WebCam, with a senior pediatrician.

As such, the parents who are literally hiding out in their own apartments during constant shelling can still click a button and benefit from the professional and senior opinion of a remote physician. Admittedly, even with present technologies, this is still not the same as having the doctor examine the child. But this will change in the near future.

Using a device like a snap on otoscope to a smart phone, or a self-contained otoscope and stethoscope from a company called Tyto, the parents can transmit a great deal of critical information to the remote doctor. Using such devices, the doctor can legitimately diagnose a middle ear infection, an asthma flareup, and possibly even a pneumonia. Children tend not to suffer from major abdominal problems [excluding appendicitis] so that a remote doctor can reasonably diagnose the most common pediatric diseases by making use of existing technologies. Of course, when the day [soon] comes that an entire specialized sensor net can identify severe infections and other abdominal complaints, this will make remote diagnosis much safer and more accurate.

What about medication delivery to people who are older or who are limited in their mobility. In general, it may be very difficult for these people to make it to the pharmacy. This difficulty is greatly exacerbated when they can find themselves in the middle of the street having to quickly find cover from a falling bomb. A few months ago, the company Amazon demonstrated how flying drones could deliver packages to customers. There are a number of logistical problems in having our skies filled with such drones as they constantly move books and other items from stores to customers’ homes. But in a time of war, such technology could be used to deliver critical medications to housebound patients, and potentially even life-saving devices to a medical team that is managing a patient in the middle of the street.

I should point out that specifically with drones, there are some significant downsides which are well described in this recent article. But to be clear, there is a huge difference between personal entertainment value of such a technology versus its use in times of crisis and war. I personally believe that such easy to handle and low-cost drones will become part of the standard set of tools available to essential services.

While Israel has to deal with her enemies on a day-to-day basis, the same technologies are of great value even in the United States. Natural disasters can make it impossible for people to get to essential services, making it of the highest priority to get essential services to people. Drones, for example, could be used to set up ad hoc communication networks so that people’s mobile phones could still be a lifeline, even when the entire surrounding infrastructure has been destroyed. Whatever the enemy might be, whether rockets or weather, such technologies for remote healthcare are clearly essential.

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